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This Perspectives article reflects on findings from our systematic review about adolescent dysmenorrhoea Q, drawing on sociology of diagnosis theory. We consider tensions and uncertainties between presentation with symptoms of dysmenorrhoea and processes of symptom categorisation and diagnosis in adolescents, tracing these through research and clinical guidance, considering possible implications for clinical practice. We argue that challenges in distinguishing between primary and secondary dysmenorrhoea in research translate into challenges in differentiation in clinical practice. We argue that framing this distinction as clear cut and straightforward belies the well-documented challenges in diagnosis of endometriosis, and that not recognising uncertainty and complexity inherent in this task may benefit neither clinicians nor patients. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the author discusses various topics within the issue including the sociology of diagnosis, digital addiction, and neuro-reductionism in the diagnosis of diseases.

The sociology of diagnosis has shown that diagnosis not only serves to label the underlying cause of disease but also to provide access to services and resources. Elaborating on this double‐affordance of diagnosis, this article examines how precision medicine reconfigures diagnosis as a label and as a process in regulatory and clinical settings. Reporting from an ethnographic case study of the introduction of immunotherapy for lung cancer, the paper unfolds the uncertainties involved in dissecting diagnosis into layers and examines the efforts and negotiations it takes to enable these layers to work both as clinical entities and regulative entities with the purpose of delineating access to treatment. I suggest that the work of subdividing diseases into molecularly defined categories for the purpose of delineating treatment‐eligible populations can be labelled 'diagnostic sub‐stratification' and argue that it is pertinent to understand the political capacity of this strategy. Diagnostic sub‐stratification involves a push of diagnosis from the clinic 'up' into the regulatory system and 'out' into the laboratories, obscuring who is accountable for the diagnostic categories employed to define patients' treatment access. [ABSTRACT FROM AUTHOR]

We bring together insights from the sociology of diagnosis and the sociology of ignorance to examine the early diagnostic unfolding of 'Long COVID' (LC). Originally described by patient activists, researchers set out to ponder its unwieldy clinical boundaries. Using a scoping review method in tandem with qualitative content analytic techniques, we analyse medicine's initial struggles to construct a LC diagnosis. Paying attention to the dynamics of ignorance, we highlight three consequential conceptual manoeuvres in the early classifications of LC: causal agnosticism concerning the relationship between COVID‐19 and LC, evasion of lumping LC with similar conditions; and the predictable splitting off of medically explainable cases from the LC designation. These manoeuvres are not maleficent, inept or unreasonable. They are practical but impactful responses to the classificatory dilemmas present in the construction of diagnoses amidst ignorance. Although there are unique aspects to LC, we suggest that its early fate is nevertheless emblematic of medicine's diagnostic standardisation processes more generally. To varying degrees, diagnoses are ignorance management strategies; they create a pathway through the uncertainty at the core of disease realities. However, while diagnoses circumscribe some types of ignorance, they produce others through the creation of blind spots and paths not taken. [ABSTRACT FROM AUTHOR]

This Perspectives article reflects on findings from our systematic review about adolescent dysmenorrhoea Q, drawing on sociology of diagnosis theory. We consider tensions and uncertainties between presentation with symptoms of dysmenorrhoea and processes of symptom categorisation and diagnosis in adolescents, tracing these through research and clinical guidance, considering possible implications for clinical practice. We argue that challenges in distinguishing between primary and secondary dysmenorrhoea in research translate into challenges in differentiation in clinical practice. We argue that framing this distinction as clear cut and straightforward belies the well-documented challenges in diagnosis of endometriosis, and that not recognising uncertainty and complexity inherent in this task may benefit neither clinicians nor patients.

Bipolar disorder has risen in prominence in recent years, arguably in part through its association with various celebrities and positive related attributes such as creativity. The category itself has also widened with increasing numbers seeking out the diagnosis. Drawing upon observations of a psychoeducation programme for bipolar disorder and semi-structured interviews with those diagnosed, this paper considers the role of diagnostic prestige and essentialism in shaping identificatory practices surrounding bipolar disorder. The data suggests that bipolar comes to fulfil a meaningful explanatory role for participants, providing an important sense of group belonging and identity.This tendency to positively relate to bipolar in order to promote social cohesion and positive self-understandings is linked to the practice of ‘strategic essentialism’ (Spivak, 1990; Voronka, 2017), whereby category homogeneity is emphasised. The benefits associated with the diagnosis arguably encourage boundary making and homogenisation in order to prevent category dilution and loss of meaning. As such, while essentialism can be helpful in maintaining group cohesion, it is also associated with diagnostic possessiveness, whereby individuals undermine the diagnostic claims of others, creating divisions between those with and without the diagnosis.

Medical sociologists highlight diagnosis as a critical moment in understanding the illness experience and have extended analysis to the growing focus on 'predisease states' in relation to policy and medical practice. The biomedicalisation of diabetes risk, labelled as 'prediabetes', is one predisease area Public Health England have prioritised via the roll-out of a national diabetes prevention programme (NDPP). The label and language of prediabetes frames this risk as a medical condition and this could have both social and practical consequences for how individuals manage this risk. Through data drawn from individual interviews and observations, we explore how individuals respond to the label of prediabetes and how they interpret and respond to their 'at-risk' status. The findings demonstrate that for some participants, the framing of risk seemed consistent with a biomedical paradigm as reflected within clinical discussions and the language used. For others, previous knowledge or experiences were drawn upon to resist, downplay and reframe their at-risk status. Our analysis reflects varying degrees of resistance where for some this seemed to mitigate against the threat of 'biographical disruption' associated with the risks of developing future diabetes. In such cases, respondents also resisted the notion that they were 'candidates'. However, in some cases, there was little resistance to the label of prediabetes, yet the perceived risk was 'low' in the context of competing health priorities or in relation to their expectations of health status in older age. Across participants, these varied responses were reflected in corresponding resistance to key messages promoting health behaviour change. [ABSTRACT FROM AUTHOR]

Little is known about the significance of cultural differences to how caregivers receive a diagnosis of neurodevelopmental disability. As part of a Fetal Alcohol Spectrum Disorder prevalence study among sentenced, detained youth, our qualitative study explored the experiences of diagnostic assessment among detained young people and their caregivers. We present findings from the perspectives of caregivers. In conversation with the sociology of diagnosis literature, we present vignettes of three Aboriginal and two non‐Aboriginal caregivers' experiences of the diagnostic assessment process. We found that Aboriginal caregivers conceptualised their children's diagnosis and ongoing management in the context of their family networks and community. In contrast, non‐Aboriginal caregivers focused on how the diagnosis would affect their child and interactions with various institutions including healthcare systems and schools. Caregivers' engagement with diagnostic reports and resources also followed cultural lines. Reflections on intergenerational drinking were voiced by Aboriginal caregivers, who expressed shame at receiving diagnosis. These findings advance our appreciation of cultural difference in receiving a diagnosis, the examination of which is in its nascent stages. We also suggest ways to mitigate harm from a stigmatising diagnosis and soften the well‐established effects of medical dominance over the process of defining a person's capacity and status. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Bulletin of Medical History is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diagnosis of autism in the UK is generally made within a multidisciplinary team setting and is primarily based on observation and clinical interview. We examined how clinicians diagnose autism in practice by observing post‐assessment meetings in specialist autism teams. Eighteen meetings across four teams based in the south of England and covering 88 cases were audio‐recorded, transcribed and analysed using thematic analysis. We drew out two themes, related to the way in which clinicians expressed their specialist disciplinary knowledge to come to diagnostic consensus: Feeling Autism in the Encounter; and Evaluating Testimonies of Non‐present Actors. We show how clinicians produce objective accounts through their situated practices and perform diagnosis as an act of interpretation, affect and evaluation to meet the institutional demands of the diagnostic setting. Our study contributes to our understanding of how diagnosis is accomplished in practice. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We analyze the implications of the diagnosis of dyslexia in the production of meanings about the experiences related to this condition, from the perspective of different social actors in different fields of interactions. We used the narratives method in dialogue with the concepts of "normality" and "pathology", "ideology" and "culture" and with the theoretical-conceptual field of "Sociology of Diagnosis". We conducted 19 narrative interviews with social actors differently positioned in the social structure, recruited from the social network Facebook, in the group "Dyslexia and Parents". We discussed the socio-historical context of social construction of the diagnostic category "dyslexia"; the pilgrimage by diagnosis, the barriers and conflicts found in the health and education systems; the importance of the biomedical diagnosis for the significance of the experience of illness by dyslexia; the role and functions of the diagnosis of dyslexia for the construction of identity marks, as well as for the search for repositioning and reordering of the daily life and for the recognition and access to rights in public spaces. The diagnosis of dyslexia was interpreted as a main character that presents positive and negative functions in the daily life of people living with this condition. [ABSTRACT FROM AUTHOR]

Diagnosis is one of medicine's most important tools. It structures the relationship between patient and diagnostician, organises illness and provides access to resources. In this article, I reveal how the manner in which a serious diagnosis is revealed creates a kind of 'epistemic posture' reinforcing the power of medical knowledge, and contributing to medical authority. To achieve this, I explore historical material written by and for doctors about the disclosure of difficult diagnoses. Using historical data for sociological purposes follows Zerubavel, who asserts that phenomena should be studied across eras, media and cultures. I have chosen to focus on how diagnostic disclosure, as described by mid-19th to mid-20th century doctors, serves to promote the profession of medicine. The means of revealing a diagnosis served as a demonstration of, and a means for deflecting threats to, medicine's esoteric nature. The historical data provide a novel approach for understanding how diagnosis operates, even today, to confirm the professional status of the doctor. [ABSTRACT FROM AUTHOR]

The diagnostic process promises a label that validates patients' embodied experiences and a road map for living with and treating illness. Drawing on 31 qualitative interviews with women and men in Canada and the United Kingdom who have been diagnosed with fibromyalgia (FM), in this article, I examine the participants' experiences of the diagnostic process and how they feel about receiving this label. The interviews reflect that the FM label is plagued by uncertainty because the diagnosis is based on the absence of verifiable pathology. The respondents' narratives also reveal that FM is a vague diagnosis that includes a multitude of symptoms, overlaps with several other diagnoses, and results in feelings of doubt regarding whether it is the correct label. Thus, the participants' narratives reflect that the FM diagnosis is largely an empty promise because it fails to provide definitive answers or confer meaning and legitimacy to their illness experiences. [ABSTRACT FROM AUTHOR]

Diagnosis is rarely a straightforward process. This is especially so in psychiatry, where diagnoses are not based on organic biomarkers (e.g., blood tests). Diagnosis can be particularly complicated for children, whose symptoms must be disentangled from typical developmental processes. In this paper, we examine how clinicians use narrative as a method for differentiating a child's autism from a possible co‐morbid seizure disorder. Our approach is conversation analysis, and we show that narrative is a pervasive and endogenous practice for producing warrantable diagnostic knowledge about patients and, as such, forms part of what we term “the practical epistemology of clinical work.” [ABSTRACT FROM AUTHOR]

The disproportionate placement of racial minorities and males into special education for learning disabilities (LDs) raises concerns that classifications occur inaccurately or inequitably. This study uses data from the Education Longitudinal Survey of 2002 to investigate the social etiology of LD classifications that persist into adolescence. Findings suggest the overclassification of racial minorities is largely consistent with (clinically relevant) differences in educational performance. Classifications may occur inconsistently or subjectively, with clinically irrelevant qualities like school characteristics and linguistic-immigration history independently predictive of disability classification. Finally, classifications may be partially biased, with male overclassification largely unexplained by this study’s measures and racial minorities’ risk of classification increased in schools with fewer minorities (the latter not statistically significant). [ABSTRACT FROM AUTHOR]

In 2017, the Danish Parliament reclassified the diagnosis used for gender-affirming treatment, officially removing it from the list of psychiatric disorders. This paper examines how trans identity was negotiated and constructed in the political debate during the years leading up to this reclassification. Through the lens of political discourse analysis, it explores how two conflicting discourses emerged in opposition to each other, out of which a liberal rights approach to trans identity gained legitimacy throughout the period in question. We argue that although the two discourses offer different problematizations of trans identity, they both entail a gender essentialist framework. • Historically, trans diagnoses belonged under the category of psychiatric disorders. • In DK, the trans diagnosis was reclassified into being non-psychiatric in 2017. • Two main opposing discourses shaped the debate leading up to the change. • While the development seems progressive, gender essentialism is maintained. [ABSTRACT FROM AUTHOR]

Social research examining patients' and caretakers' narration of mental disorders, including ADHD, has been remarkably silent about comorbidity. Centering the theme of uncertainty and the question of what is "at stake" in mothers' mental health narratives of children (Kleinman, 1988), we characterize the patchwork process by which mothers deploy ADHD and comorbid diagnoses to account for key experiences and struggles in their and their child's lives. We found that ADHD had limited purchase in accounting for the emotional and social difficulties that were most urgent in mothers' narratives, despite the medical authority behind the ADHD label, which the mothers mostly accepted. However, mothers remained pervasively uncertain about the relationship between ADHD and comorbid mental health conditions, paralleling debates on the relationship between ADHD, emotion, and comorbidity in the psychiatric and psychological literature. Our findings contribute a conceptualization of comorbidity as a web of diverse moral vocabularies, institutional outcomes and perceptions of personhood, through which mothers of ADHD children maneuver over time. Through this perspective we illustrate how ADHD is co-constructed as a narrow neurological problem of 'attention,' and demonstrate the overlooked and crucial ways that comorbidity may shape parents' pragmatic and interpretive negotiation of ADHD. Kleinman, Arthur. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books. • Sociology of diagnosis and illness experience has not kept apace with comorbidity. • We show how mothers narrate their children's ADHD in light of comorbid diagnoses. • Comorbidity shapes mothers' pragmatic and interpretive negotiation of ADHD. • The unequal cultural and institutional status of diagnoses shapes narrative processes. • Mothers' diagnostic uncertainty parallels professional controversies. [ABSTRACT FROM AUTHOR]

Copyright of Dansk Sociologi is the property of Djøf Forlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

More than 100,000 mobile phone software applications (‘apps’) have been designed for the dissemination of health and medical information and healthcare and public health initiatives. This article presents a critical analysis of self-diagnosis smartphone apps directed at lay people that were available on the Apple App Store and Google Play in mid-April 2014. The objective of the analysis is to contribute to the sociology of diagnosis and to critical digital health studies by investigating the phenomenon of digitised diagnosis via apps. We adopted a perspective that views apps as sociocultural artefacts. Our analysis of self-diagnosis apps suggests that they inhabit a contested and ambiguous site of meaning and practice. We found that app developers combined claims to medical expertise in conjunction with appeals to algorithmic authority to promote their apps to potential users. While the developers also used appeals to patient engagement as part of their promotional efforts, these were undermined by routine disclaimers that users should seek medical advice to effect a diagnosis. More research is required to investigate how lay people are negotiating the use of these apps, the implications for privacy of their personal data and the possible effects on the doctor–patient relationship and medical authority in relation to diagnosis. [ABSTRACT FROM AUTHOR]

This paper explores the narrative behind Becel®'s pro.activ® calorie-reduced margarine advertising campaign. Becel® pro.ac tiv® is a new functional food product developed with plant sterols that claims to lower cholesterol and is the first food product available for purchase in Canada with plant sterols. The campaign consists of s ix advertisements specifically targeted to women in two Canadian magazines ('Canadian Living and More,/ over the course of six months from September 2010 to February 2011. Using a sociology of diagnosis framework, I argue that these advertisements create a false sense of urgency and empowerment surrounding high cholesterol for women, and reinforcea "healthy life style discourse" that individualizes the responsibility for health, potentially disenfranchising the individual, patient and consumer. Using frame analysis, I argue that Becel®'s pro.activ® campaign constructs high cholesterol as a disease; simultaneously frightens and empowers women; and lastly, privileges and promotes the individual notion of personal responsibility for health. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (lupus) is a complex condition characterised by wide ranging symptoms that are sometimes transient in nature. This makes recognising and diagnosing lupus particularly challenging for both patients and practitioners. The diagnostic process in this condition is a complex interplay between the boundaries of knowledge and power, control, integrity and legitimacy, which are (re)constructed and (re)negotiated between contemporary medicine, the patient and practitioner. Utilising data generated through a qualitative research design, this article illustrates some of the challenges lupus presents in the clinical encounter. We argue that the diagnosis of lupus is not a clinical event or a ‘diagnostic moment’. Rather, it constitutes a journey in and of itself, one which, for many of the respondents in this study, has no diagnostically satisfying conclusion. We conclude that uncertain diagnoses, such as lupus, illustrate the extent of both embodied and clinical doubt in, what might be termed, contemporary conditions and, concomitantly, throw into sharp relief the nature of the diagnostic process. This process, in the context of lupus, and other uncertain conditions, generates, we would argue, a sense of diagnostic vertigo. [ABSTRACT FROM PUBLISHER]

Abstract: Using a sociology of diagnosis approach, this paper discusses the implication of high cholesterol being promoted as a disease rather than a risk factor for cardiovascular diseases. Drawing on data collected during the spring/summer of 2012 from 49 in-depth interviews with women over the age of forty concerned with high cholesterol in Ontario, Canada, I explore participants' understanding of the issue of high cholesterol as a disease. More specifically, I examine where blame and responsibility for high cholesterol are placed and if they vary by women's class background. My findings reveal that all the participants believed in and internalized the diagnosis of high cholesterol. However, the disease is blamed on ‘lifestyle choices’, and individual responsibilities, while women's awareness of the social determinants of health varies by class. I argue the sense of urgency surrounding high cholesterol is worrisome and the sole focus on lifestyle choice as both the cause and solution to high cholesterol is problematic for three reasons: it assumes that individual responsibility is adequate; it minimizes the socioeconomic constraints women face on a daily basis; and it reinforces the idea that individuals can be blamed for their health problems. [Copyright &y& Elsevier]

Abstract: discuss diagnosis as not only a major classification tool for medicine but also an interactive social process that itself may have ramifications for health. Consideration of diagnosis as a social determinant of health outcomes led to the formulation of our research question: Can we detect a change in the development of prosocial symptoms before and after an Autism Spectrum Disorder (ASD) diagnosis? We examined the developmental trajectory of prosocial skills of children, as impairment in social skills is given as a core symptom for children with ASD. We used a validated scale measuring prosocial behaviour for a sample of 57 children where the measure was repeatedly recorded over ten years. We plotted the developmental trajectory of the prosocial trait in this sample who were enrolled in a longitudinal birth cohort study based in South West England. Multi-factorial fixed effect modelling suggests that the developmental trajectory of this measure of behaviour was not significantly altered by ASD diagnosis, or the consequences of diagnosis, either for better or worse. Further analysis was conducted on a subset of 33 of the children who had both pre-diagnosis and post-diagnosis information, and the same result obtained. The results indicate that prosocial behaviours may be resistant to typical ‘treatments’: provision of educational and specialist health services triggered by a clinical ASD diagnosis. The implications of this for considering diagnosis as a social determinant are discussed. [Copyright &y& Elsevier]

Abstract: Disease classification is an important part in the process of medicalisation and one important tool by which medical authority is exerted. The demand for, or proposal of a diagnosis may be the first step in casting life''s experiences as medical in nature. Aronowitz has written about how diagnoses result from social framing mechanisms (2008) and consensus (2001), while has demonstrated a complex range of interactions between lay and professionals, institutions and industries which underpin disease discovery. In any case, there are numerous social factors which shape the diagnosis, and in turn, provide a mechanism by which medicalisation can be enacted. Focussing on diagnostic classification provides an important perspective on the human condition and its relationship to medicine. To illustrate how layers of social meaning may be concealed in a diagnosis, this paper uses as heuristic the relatively obscure diagnosis of Female Hyposexual Desire Disorder which is currently surfacing in medical and marketing literature as a frequent disorder worthy of concern. I describe how this diagnosis embodies long-standing fascination with female libido, a contemporary focus on female hypersexuality, and commercial interest of the pharmaceutical industry and its medical allies to reify low sexual urge as a pathological disorder in women. [Copyright &y& Elsevier]

Sociopolitical forces commonly influence the collection, analysis, dissemination, and general perceptions of epidemiological information. Yet few theoretical lenses provide insight into the mechanisms through which such influence occurs. In this article, I draw and expand upon empirical findings to propose a novel theoretical lens, politicized disease surveillance , which I define as extreme or undue sociopolitical influence on public health surveillance systems or processes in ways that impact disease incidences and prevalences, or estimates or perceptions thereof. This lens foregrounds disease incidence and prevalence as objects of contestation and policy influence and articulates how certain facets of sociopolitical forces shape disease incidences and prevalences—especially amid an epidemic—through one or more channels: (1) the diagnostic construct; (2) screening tools, procedures, or systems; or (3) the behaviors of individuals who are living with or at risk for a certain disease. I provide several contemporary illustrations of politicized disease surveillance and discuss its theoretical and practical implications. • Sociopolitical forces influence epidemiological systems and disease realities. • This article proposes a novel theoretical lens, politicized disease surveillance. • The theory examines extreme or undue sociopolitical influence on public health. • It analyzes various types of sociopolitical impact and channels and tools used. [ABSTRACT FROM AUTHOR]

Social science literature has documented how the concept of diagnosis can be seen as an interactive process, imbued with uncertainty and contradiction, which undermines a straightforward notion of diagnosis as a way to identify underlying biological problems that cause disease. We contribute to this body of work by examining the process of resolving contradiction in autism diagnosis for adults and adolescents. Autism is a useful case study as diagnosis can be a complex and protracted process due to the heterogeneity of symptoms and the necessity to interpret behaviours that may be ambiguous. We audio-recorded and transcribed 18 specialist clinical assessment meetings in four teams in England, covering 88 cases in two adult, one child and one adolescent (14+) setting. We undertook a qualitative analysis of discursive processes and narrative case-building structure utilised by clinicians to counteract contradiction.We identified a three-part interactional pattern which allows clinicians to forward evidence for and against a diagnosis, facilitates their collaborative decision-making process and enables them to build a plausible narrative which accounts for the diagnostic decision. Pragmatism was found to operate as a strategy to help assign diagnosis within a condition which, diagnostically, is permeated by uncertainty and contradiction. Resolution of contradiction from different aspects of the assessment serves to create a narratively-coherent, intelligible clinical entity that is autism. • Diagnosis of autism in adults and young people can be complex and contradictory. • Discursive analysis examined how teams deliver a coherent diagnostic narrative. • An interactional pattern in team decision-making helps to resolve contradiction. • Considering social outcomes is used as a strategy to help assign diagnosis. • This decision-making process contributes to how we understand autism. [ABSTRACT FROM AUTHOR]

Currently, we are witnessing a precipitous rise in autism diagnoses among children, and several bodies of sociological research are attempting to explain this development. However, the experiences within parental contexts have been inadequately examined; that is, how parents feel about and act upon the awareness of their child's autism diagnosis. Drawing upon a qualitative study among Danish parents of 20 children recently diagnosed with autism, this paper contributes with situated insights into parents' experiences. We identify a spectrum of feelings towards the autism diagnosis, including both relief and grief. In the absence of theoretical notions drawing attention to how a child's diagnosis influences parents' self-conceptions and understandings of their child, we develop the concept of 'parent-biographical disruption': the parents' rethinking of themselves and their child that might be caused by a chronic condition such as autism. Based on the variety of findings, we discuss what we call 'parent-biographical cohesion' as a counterpart to 'disruption'. By 'cohesion' we refer to the diagnostic awareness potentially creating clarification for parents about the past, present and future parenting of their child instead of disrupting their self-understandings as parents. In this way, through the notion of a parental-biographical spectrum of disruption and cohesion, we emphasize the diversity in how parents deal with a child's autism diagnosis and the variety of needs for rethinking parental biographies in the wake of a diagnosis. • Situated insights into parents' experiences with their child's autism are offered. • Grief and relief prompt a variety of reasons for rethinking parental biographies. • The diagnosis of autism functions as a trigger for both disruption and cohesion. • A parent-biographical spectrum of disruption and cohesion is conceptually anchored. • Parent-biographical cohesion is when a child's autism creates meaning in hindsight. [ABSTRACT FROM AUTHOR]